Multisensory Training for Hemianopia

Overseen By Benjamin A Rowland, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Wake Forest University Health Sciences

Must not be taking: Safety-influencing drugs

Disqualifiers: Major medical problems, Neurological disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 64 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether special training can improve vision in people who have lost half of their sight due to a stroke. It examines two groups: those with long-term vision loss and those who recently experienced it after a stroke. The study compares multisensory training, which uses multiple senses, to unisensory training, which focuses only on hearing. It suits individuals with stable vision loss for over six months or new vision loss within the last month. Participants must have normal daily cognitive functions and reliable transportation to attend study sessions. As an unphased trial, this study offers a unique opportunity to contribute to groundbreaking research that could enhance vision recovery strategies.

Will I have to stop taking my current medications?

The trial does not specify if you must stop taking your current medications, but it excludes those taking medication that could negatively influence safety during the intervention. It's best to discuss your specific medications with the study team.

What prior data suggests that this multisensory training technique is safe for hemianopic stroke patients?

Research shows that multisensory training for hemianopia, which uses different senses to improve vision, is generally safe. Studies with participants have not identified any major safety issues. Most research indicates that it is well-tolerated, with no significant side effects. This suggests the training is safe for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about multisensory training for hemianopia because it offers a novel approach compared to traditional therapies. Most existing treatments focus on visual rehabilitation alone, but this method combines visual and auditory stimuli, potentially enhancing brain adaptability and recovery. This integrated approach may accelerate improvements in spatial awareness and visual field restoration, especially promising for patients who have had little success with standard therapies. Additionally, the early intervention with multisensory training could provide significant benefits for those diagnosed within a month, potentially preventing long-term visual impairment.

What evidence suggests that this trial's treatments could be effective for hemianopia?

Research has shown that training involving multiple senses can improve vision in people with hemianopia, a condition where half of the visual field is lost. In this trial, participants will receive either Multisensory Training or Unisensory Training. Studies have found that multisensory training can quickly restore vision by engaging different senses during recovery. A review of 16 studies confirmed that using both sound and sight in rehabilitation significantly improves vision problems caused by strokes. Additionally, this training can be effectively conducted from home through telerehabilitation, allowing for remote participation. These findings suggest that this method could be a promising option for those seeking to improve their vision after a stroke. ^{6 7 8 9 10}

Who Is on the Research Team?

Benjamin A Rowland, PhD

Principal Investigator

Wake Forest University Health Sciences

Are You a Good Fit for This Trial?

Adults over 18 with stable homonymous hemianopia for at least 6 months, or new cases less than a month old. Participants must speak English, be cognitively normal, have reliable transportation, and be MRI compatible. Exclusions include current major medical issues affecting cognition or vision, substance abuse, other neurological disorders like dementia or Parkinson's disease.

Inclusion Criteria

I have been diagnosed with vision loss on the same side of both eyes for over 6 months.

Can safely undergo an MRI scan.

You are able to do daily activities without a problem, or a recent test showed that your memory and thinking are normal.

Exclusion Criteria

A doctor has not excluded me from the study due to stroke symptoms.

I am on medication that may not be safe with the trial treatment.

I do not have major health issues affecting my thinking, sight, or ability to attend study visits.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive multisensory or unisensory training depending on their group assignment

64 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

12 months

What Are the Treatments Tested in This Trial?

Interventions

• Multisensory Training
• Unisensory Training

Trial Overview

The trial is testing multisensory training to improve vision in patients with blindness caused by stroke. It compares the effectiveness of this technique on those with long-standing blindness versus those recently affected.

How Is the Trial Designed?

Group I: Standard Intervention: Multisensory Training Experimental Treatment 1 Intervention

Patients with stable hemianopia (\>6 months) are given multisensory training

Group II: Early Intervention: Multisensory Training Experimental Treatment 1 Intervention

Patients with early hemianopia (\<1 months) are given multisensory training

Group III: Standard Intervention: Unisensory Training Active Control 2 Interventions

Patients with stable hemianopia (\>6 months) are given auditory training and crossover to multisensory training

Group IV: Early Intervention: Unisensory Training Active Control 2 Interventions

Patients with early hemianopia (\<1 months) are given auditory training and crossover to multisensory training

Who Is Running the Clinical Trial?

Wake Forest University Health Sciences

Lead Sponsor

Trials

1,432

Recruited

2,506,000+

Published Research Related to This Trial

Visual-auditory stimulation therapy has shown promising results in restoring visual sensitivity in two male patients with hemianopia, a condition typically considered permanent after stroke, with significant improvements observed within a few weeks.

Both patients were able to detect, describe, and localize visual stimuli in their previously blind field, demonstrating that this multisensory approach can effectively enhance visual function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ameliorating Hemianopia with Multisensory Training. Rowland, BA., Bushnell, CD., Duncan, PW., et al.[2023]

A cohort study involving 19 patients (7 with neglect and 12 with neglect and hemianopia) showed that 10 sessions of multisensory audio-visual stimulation significantly improved clinical signs of neglect, with these improvements lasting for months after training.

The study suggests that the benefits of this training may be linked to activity in subcortical structures like the superior colliculus, which play a role in integrating sensory information and spatial orientation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioural and functional changes in neglect after multisensory stimulation. Làdavas, E., Tosatto, L., Bertini, C.[2022]

A novel approach using passive auditory stimulation significantly improved visual detection in patients with hemianopia, showing nearly a 100% increase in performance shortly after stimulation on the blind side.

The improvement in visual detection was temporary, lasting about 1.5 hours, suggesting that auditory stimulation may activate residual visual pathways, highlighting a potential new method for rehabilitation of visual field disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Passive auditory stimulation improves vision in hemianopia. Lewald, J., Tegenthoff, M., Peters, S., et al.[2021]

A new rehabilitation approach using audio-visual stimulation showed promising results in improving visual field defects in 8 patients, with training sessions lasting 4 hours daily over nearly 2 weeks.

Patients demonstrated significant improvements in visual detection and oculomotor exploration, which translated to better performance in daily activities, with benefits lasting up to one month after treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Visual search improvement in hemianopic patients after audio-visual stimulation. Bolognini, N., Rasi, F., Coccia, M., et al.[2019]

In a study of 21 patients with hemianopia, 4 weeks of compensatory visual field training significantly improved their ability to detect and react to visual stimuli when using exploratory eye movements, with these improvements lasting for 8 months.

Despite the training enhancing visual detection and reaction times, the actual size of the visual field defect (scotoma) did not change, indicating that the training improved functional abilities without restoring the lost visual field.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Compensatory visual field training for patients with hemianopia after stroke. Nelles, G., Esser, J., Eckstein, A., et al.[2022]

Citations

1.

jneuroengrehab.biomedcentral.com

jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-025-01573-4

Telerehabilitation for visual field defects with a multisensory ...

Multisensory training delivered in telerehabilitation is feasible and effective for ameliorating oculomotor compensation of visual field loss, ...

2.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC9908311/

Ameliorating Hemianopia with Multisensory Training - PMC

These results indicate that the multisensory therapy is a rapid and effective method for restoring visual function in hemianopia.

3.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/39994637/

Telerehabilitation for visual field defects with a ...

Conclusion: Multisensory training delivered in telerehabilitation is feasible and effective for ameliorating oculomotor compensation of visual ...

4.

clinicaltrials.gov

clinicaltrials.gov/study/NCT04963075

NCT04963075 | Multisensory Rehabilitation of Hemianopia

Once recovery of visual responsiveness in the contralesional field is observed, sessions will alternate between "training/testing" and "testing only" sessions ...

5.

strokeguideline.org

strokeguideline.org/app/uploads/2023/02/Q23-evidence-table.pdf

Question 23: What is the effectiveness of interventions ...

Systematic review on effectiveness of interventions that use Audio-Visual (AV) multisensory training as rehab for post stroke visual field defects. 16 studies ...

6.

clinicaltrials.gov

clinicaltrials.gov/study/NCT05894434

Ameliorating Stroke-induced Hemianopia Via Multisensory ...

This study seeks to determine the extent of the visual capabilities that can be restored in hemianopic stroke patients by a multisensory training technique ...

7.

sciencedirect.com

sciencedirect.com/science/article/pii/S2589537024005340

A telerehabilitation program to improve visual perception in ...

This study aimed to explore the feasibility, safety, and potential effectiveness of a home-based audiovisual stimulation in immersive virtual-reality (3D-MOT- ...

8.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC4762927/

Multisensory Stimulation to Improve Low- and Higher-Level ...

Overall, twenty out of twenty-one studies reported a beneficial effect of multisensory stimulation in improving sensory deficits.

9.

withpower.com

withpower.com/trial/phase-blindness-3-2024-49f96

Multisensory Training for Hemianopia · Info for Participants

The studies on multisensory training for hemianopia in humans do not report any safety concerns, suggesting it is generally safe. The training involves visual- ...

10.

trialx.com

trialx.com/clinical-trials/listings/223211/multisensory-rehabilitation-of-hemianopia/

Multisensory Rehabilitation of Hemianopia

The over-arching objective is to evaluate the functional recovery of vision in hemianopic patients engaged with a multisensory training paradigm ...